International Surgery Journal | June 2018 | Vol 5 | Issue 6 Page 2081 International Surgery Journal Jha PK et al. Int Surg J. 2018 Jun;5(6):2081-2085 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Pattern of ileal perforation in our experience; a tertiary care centre in Eastern India Pawan Kumar Jha, Rajnish Chandran*, Pradeep Jaiswal, Anurag Kumar, Kumari Seema, Digbijay Kumar Singh, Ashwini Kumar, Mukesh Kumar INTRODUCTION Ileal perforation is common acute abdomen problem admitted in surgical emergencies. It is vital to diagnose early as the prognosis depends on accurate diagnosis and its management. Worldwide incidence of typhoid fever is decreasing but still this is endemic in India. 1 Ileal perforation may be categorised as traumatic and non- traumatic. Etiological factors associated with non- traumatic perforations are typhoid fever, intestinal tuberculosis, round worm infestation, malignant tumours of small intestine etc. 2 Traumatic perforation may be in the form of blunt abdominal trauma or penetrating injury causing perforation of ileum, may or may not associated with injury to other abdominal viscera. 3 Advanced medical facilities have changed the etiological patterns of non-traumatic ileal perforation but still non- traumatic perforation is commoner than traumatic perforation in developing countries. But in western countries the typhoid and tuberculous perforation is rare. In developed countries most common aetiology remains vascular strangulation, foreign bodies ingestion, ABSTRACT Background: Perforation peritonitis is one of the common acute abdomen admitted in emergency department for emergency laparotomy. Pattern and aetiology of ileal perforation varies from developed and developing countries where infectious diseases are still highly prevalent. Methods: This was a prospective study conducted over 3 years period in Indira Gandhi Institute of Medical Sciences, Patna. Total 118 patients were enrolled for this study after confirmation of ileal perforation on exploratory laparotomy. Results: Out of total 118 patients 52 cases (44%) were in traumatic, typhoid causes perforation in 86% (57 cases) tuberculosis in 14% (9 cases) and 66 cases (56%) were in non-traumatic group, penetrating injury is more common than blunt trauma abdomen. Males are more commonly affected than females in among all cases of ileal perforation. Patients with traumatic ileal perforation seek early medical attention as most of the patients (44%) admitted within 12 hours after accident where as in case of non-traumatic cases 53% patients admitted after 2 days. Most common operative procedure performed is Loop ileostomy in case of non-traumatic perforation (49%) and Resection and anastomosis preferred in traumatic perforation (63%). Mortality rate is about 20% in all types of perforation. Conclusions: In developing countries like India typhoid perforation is still most common cause of ileal perforation. Loop ileostomy is more preferred procedure in infectious cases but resection and anastomosis in case of traumatic perforation in our institute. Keywords: Ileal Perforation, Non-traumatic perforation, Typhoid, Tuberculosis Department of General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India Received: 19 April 2018 Accepted: 24 April 2018 *Correspondence: Dr. Rajnish Chandran, E-mail: rajnish_chandran@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20181996